Resilience and Covid-19

Integrative Medicine Recommendations

As the coronavirus spreads through our country, engaging in deeply nourishing self care is a way of caring for our community. The more we stay home, remain separated, wear masks in public, and wash our hands, the less likely this virus is to move through our inner circles, our household, our community.

Additionally, there is much we can do to keep ourselves strong and resilient so that if we do become exposed to the virus, as so many of us will, we have the best chance of fighting it off.

 

Here is what we know:

  • This virus is very contagious. It is anticipated that between 40 and 70% of people in our country will become infected in the coming months.

  • Most people will only have a mild illness.

  • Some infected people have no symptoms and yet still transmit the virus.

  • Some people, particularly those over age 60 and with chronic health conditions like diabetes, heart disease, high blood pressure or lung disease, can become very sick, and many could die.

  • There is an inflammatory reaction that happens in many of the critically ill patients that makes the risk of death higher. Referred to as "cytokine storm", it is an overwhelming immune reaction that floods the body with "cytokines" that create harm.

  • It is essential that we all work together to slow the spread of this virus so that our hospitals are not overwhelmed with more sick people than they can take care of. Our country does not have enough ventilators to care for the anticipated number of critically ill patients.

  • The best way we can slow the spread is to stay at home, away from gatherings large and small.

  • Refrain from hugging and handshaking. Connect with your eyes, your kindness, your energy.

  • Handwashing frequently, avoiding touching your face, and disinfecting surfaces with cleansers containing alcohol, bleach or peroxide helps prevent transmission. Pay particular attention to counters, doorknobs and handles such as to sinks and toilets.

 

Focusing on these important strategies in your home and workplace is essential. Letting go of plans, keeping our children separated from our vulnerable elders, and checking in on neighbors to make sure they have what they need is very important. Doing everything we can to support our immune system and decrease inflammation is important both for our individual health and the health of our community. Now is the time to be making wise choices. Here are my recommendations:

 

  • Good sleep is central to immune function; in fact, the immune system is regulated by the circadian rhythm. Here is a link to a very comprehensive handout on things you can do to support your sleep. Optimizing our circadian rhythm by waking with the sun (not an alarm), having morning sun (between 8 am and noon) on your face, winding down in the evening after the sun has set, and avoiding blue spectrum light at night supports the immune system and dampens inflammation. If you have sleep apnea, please try to treat it with CPAP if necessary.

  • Choose brightly colored fruits and vegetables, and lots of them. Aim for seven to ten to servings of brightly colored veggies and fruits each day. Make a big pot of vegetable broth and sip it as a tonic throughout the day. Plants are full of "flavonoids" which dampen inflammation and support the immune system.  Onions and apples are full of quercetin, which has been shown to be particularly effective in decreasing coronavirus' ability to bind to cellular receptors and decrease the harmful inflammatory response. 

  • Many easily grown herbs are anti-viral and immune supporting. Rosemary, oregano and thyme are great to include in a big pot of vegetable broth, as is garlic. Most spices, especially turmeric, ginger, cinnamon, cardamom, cumin are anti-inflammatory and immune supportive, and have anti-microbial effects too. Turmeric, in particular, has been shown to block entry of the virus into cells and decrease the inflammatory response.

  • Many plants that grow in the wild are strongly supportive of the immune system. Yerba buena is high in quercetin, yarrow high in apigenin, both of which block the inflammatory cytokines released during the "cytokine storm". Miner's lettuce, nasturtium and chickweed are all high in vitamin C, so essential for our immune function. See here for more immune supporting wild greens and herbs.

  • Strictly avoid immune suppressing and inflammatory foods like sweets, sugar, and processed foods with lots of chemicals in them, and excessive alcohol. Avoid glutenous grains, minimize dairy.

  • If you have diabetes or high blood pressure, work with your health practitioner to get it under optimal control. Many health centers are offering phone appointments to keep healthy and sick people alike out of the medical setting. 

  • If you smoke, please stop. It hurts your lungs and suppresses your immune system. Get help to do so.

  • Getting exercise boosts the immune system and is anti-inflammatory. Walks in nature are especially beneficial.

  • Being in nature boosts the immune system and decreases inflammation. Fresh outdoor air and sunshine support our ability to recover from viruses, and may be directly antiviral. Trees release phytochemicals that are antiviral and immune supporting. Gardening, with your hands in healthy soil supports healthy immune function and our microbiome.

  • Stress and anger inflame and suppress the immune system. An episode of anger suppresses the immune system for 6 hours! Let go of what you can, and get help navigating difficult emotions if needed.

  • A strong “vagal tone”, meaning, a strong “rest and digest” (as opposed to fight or flight) nervous system supports the immune system and decreases inflammation. A meditation or prayer practice supports this, as does giving and receiving love, singing, dancing, swimming in cold water, laughing, petting a pet, appreciating beauty, listening to music. Helping others helps ourselves.

  • Keep yourself hydrated. Do try for 8 cups of water or herbal tea a day. Avoid caffeine and alcohol.

  • Immune supporting and anti-inflammatory herbs and supplements may be helpful. However, they will be so much more effective if you partner with them by doing the above things. Here is what I am recommending/taking. I've bolded those I would prioritize if you were to choose just a few. Again, our behaviors and dietary choices are more important than the supplements we take.

    • General immune support:

      • Vitamin D 2000 IU/D (increases our innate immune response)

      • Vitamin C 1000-2000 mg/d

      • Astragalus (tincture or capsule): may block the virus from binding to the ACE2 receptor

      • Zinc: may block viral replication

      • Licorice (I’m drinking a tea-be cautious if you have high blood pressure)

    • First sign of illness:

      • Immune:

        • Vitamin D 10,000 IU/day for two days, then stop**

        • Elderberry (tincture or syrup)--best used for only the first couple of days as it could theoretically overstimulate inflammatory response**

        • continue Astragalus (tincture or capsule)

        • Licorice tea

      • Anti-inflammatory:

        • Omega 3 fatty acids (EPA/DHA): 2000 mg/day

        • Curcumin: decreases specific inflammatory cytokines activated in "cytokine storm"

    • Post-viral lingering cough

      • Demulcent herbs in tea form: licorice, slippery elm, marshmallow. Traditional Medicinal’s “Throat Coat” is a nice blend.

      • Honey and lemon in hot water and soothes cough

*These recommendations are made based on studies done with other viruses in the coronavirus family. We do not yet have studies of the action of these supplement on the novel coronavirus causing COVID-19. ​​​

**Once there are signs of illness, it is best to hold off on supplements that might cause an exagerated inflammatory immune response. Vitamin D, elderberry and echinacea have this potential.

This is a challenging time we are facing together. It is a good time to bring our focus on what is most important, and to reach out to and support vulnerable friends and neighbors. Be kind and compassionate. Stay home as much as possible, connect with friends and family over the phone. If you get sick, call your health care provider for advice, and stay home, isolated from others. Having a cross-draft, with windows open for fresh air may help recovery. As much as possible, sit outside in the sunshine.

 

Please feel free to share these recommendations widely.

With love and care,

Anna O'Malley, MD

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